I have spent well over a year fighting with my insurance company to reimburse me for the massive out-of-pocket expenses I have incurred during transition, all of which the medical community deems medically necessary. My battle is not unique, and I am very proud to have been able to lend my story to CNN for this piece on my community's struggle within the American healthcare system.
I was fortunate enough to have the opportunity to contribute to an article on Facial Feminization Surgery in The New Yorker, and I am proud of how well it turned out <3
I remember the feeling after my mother died. It was as if the color had been drained from the world; it was as if the floor was made of loose rubber beneath my feet; it was as if everything in the world was merely a shell – like mannequins and cardboard cutouts and marionettes had suddenly displaced the real with the nothing; it was as if I had been transported to a pretend world of tiny people and tiny things yet no one else was the wiser. I was merely twenty-one years old at the time, and at that point, in the Spring of 2010, I was lost.
It was baffling to me, as the time went by – at first days, then weeks, then months – that I seemed to be the only one who felt this way. My father, being a doctor in the city, had patients to attend to. My brother, being freshly graduated from medical school, and remaining true to form, took off for adventures in Sierra Leone, distancing himself in foreign culture wrapped in radio silence. My friends, their “I’m sorries” paid, went back to their lives. Even the dogs seemed to be getting over the loss of this mammoth figure of feminine power and grace. Yet there, I was, Austin, the lost boy, missing his mother.
So, I did what anyone does when confronted with insurmountable grief. I binged some TV the good-old fashioned way: pirating it on the Internet. Yes, this was my moment – somewhere between graduating college, starting medical school, and taking enough acid to give Timothy Leary a scare – I could finally learn the fate of Tony Soprano; I could finally understand why The Wire was “one of the best television shows ever” according to everyone who knows anything. And so, I binged, and I binged, and I binged. Days turned to weeks, and weeks turned to months, and before long, it was August, and it was time for me to get my shit together, for real.
So, I did what anyone does when they feel like they need to get their life back on track: I went back to back to school – medical school to be precise. My mother, as she lay dying, I am sure, rested easy knowing that she had achieved the greatest accomplishment that a Jewish mother could: both of her boys were going to be doctors! A sentiment so stereotypical and pure, how could I not honor it? How could I not pick up my crusty self, put down the psychedelics, and launch myself into a successful career in medicine. Indeed, how could I not, being so lost?
Med school, was, well, med school. It is everything you ever heard it is and not much more: long hours, lots of stress, and more formaldehyde than a Brazilian blowout. Well, my determination to honor my mother drove me there, and it was my ceaseless desire to really feel her smiling at my great success, as she had done so many times before, that kept me cloistered away in coffee shops with my face buried in anatomy books and disturbingly dry power points lectures. It was that lifelong desire to feel her pride that kept me glued to a militaristic schedule of eat, sleep, exercise, study, eat, sleep, exercise, study, eat, sleep, exercise, study until my very dreams contained nothing more than biochemical pathways and CrossFit workouts. And it was in this twisted existence that I tried on my first wig...
…and then, as the last light from the dying sky faded into the listless horizon, and the many creatures of the land paused to acknowledge the changing of the guard – the Sun, relinquishing its fiery hold unto the elegant embrace of the heavenly stars – a stillness swept across her soul, and a calm settled into the oceans of her being; she slept, but for a time, only to rise again.
The pursuit of happiness, it is what we are all after, is it not? While there is absolutely nothing wrong with the quest to experience joy and jubilation, we have, as a culture, twisted this into something sinister; happiness is, by its very nature, a fleeting emotion as transient as a break in the clouds on a rainy day in April. Yet we, the Millennials, grew up with this notion – courtesy of our Baby Boom parents and the never-ending deluge of American commercialism fed daily to us through our television sets – that our purpose in life was to achieve a sustained state of happiness. Yet this is a task doomed for failure; indeed, there is an ocean of difference between the pursuit of happiness and the pursuit of undying happiness, and while the former is a process the latter is a state, and while the former is achievable the latter is a fool’s errand. It is akin to hoping that if you leap into the air enough times, sooner or later, you will fly. Yet we know that we cannot fight the pull of gravity, just as we cannot fight the pull of our other emotions. Because that is what happiness is: a grain of sand on a beach, a drop of water in a lake, a single breath in our lifetime, and just as it is impossible to hold our breath forever, we cannot hold on to happiness just the same. We can, however, hold on to the pursuit of it, and that is what I want us all to do.
We live in a time, when people struggle to be alone. I certainly did. I cannot count the number of times I found myself alone with my thoughts, with my emotions, with my shame, and my guilt, and my sadness, and the infinite emotional hues of the human condition. I cannot count the number of times, that in those moments of pure existentialism, I panicked; I did so because in those moments, I had to confront the essence of who I was. I had to confront an unenviable truth: I did not like who I was. So many of us, as we grow – from the undetected life force in our mothers’ wombs to the angsty teenagers who act as if they know all there is to know – allow the world and its many opinions to define who we are. We allow our parents to define who we are. We allow that boy in our middle school class to define who we are. We allow the pressures of our immediate surroundings to define who we are. We allow everyone and everything except ourselves to define who the fuck we are. Simultaneously, we find ourselves grasping at a goal that is so impossible that I laugh to myself as I write this sentence. Happiness? Really? This is what we are told we are looking for, and we believe it? It seems so fucking logical that we do not even stop to ask: is this a realistic goal? Take a second. Let that question really sink in.
Yeah, that’s how I feel too. That is how I felt when I left medical school, against all of the pleadings of the world around me: “Don’t leave! What will you do? You would make such an incredible physician. Don’t waste such an amazing opportunity. People would kill to be in your shoes.” These were the words that fell upon me, a hailstorm of opinions and prescriptions, that – in the context of my mother’s death – seemed meaningless. I had lost the one person who, I felt, really understood me. I had lost the person who called me every evening to ask, “How are you doing?” and genuinely mean it. I had lost the person who gave her life so that I could live mine. I had lost the person who held my hand when I was sick. I had lost my mother, and she was everything to me. And I was, decidedly, not fucking happy about it in the slightest. My mom told me, hours before her heart stopped, “I just want you do what makes you happy,” but there I was, in medical school, resisting my gender identity, dragging everyone and everything into the maelstrom of pain and suffering that defined every minute of my day. Even my dreams were not free anymore; they too were riddled with the cries of my damaged soul.
So, I set out to do what my mother said she wanted me to do, and in doing so, I made one decision after another that led me to where I am today. I set out to pursue happiness, not find it, and it was in that journey that I came to realize that what I was seeking, so desperately, was right there in front of me, like a thirsty wanderer in the desert unable to see the oasis before them – and believe me when I say that I was seriously fucking parched. We are all seriously fucking parched. So, please, stop looking for the oasis that never dries up. New flash, they all dry up. Life, however, is filled with one after the next, after the next, after the next, until you die – not from the heat of the Sun or the lack of hydration, but from a full and meaningful life spent searching for that next unseen fountain. It is that love of the journey that will produce moments of happiness. It will produce moments of fear, and doubt, and sadness, and pain, but you cannot escape those, and that well that you are clinging to – whether it is your family, your job, your spouse, or your new fucking car – it too will dry up, and when it does, it will be that way forever. You will die there if you do not do what you have to; you have to pick your thirsty ass up and move. One day at a time, you have to move, and you have to search, and you have not stop, because that too will kill you. And if you die, how can you help those whom you love? If you die, how can you help yourself?
If you are still afraid, then let me help you. Let me be that beacon of hope, for this is my calling in life: to overcome tragedy and identity, and share how I did it; to stand in this desert of life, fearless, guiding lost wanderers to that next oasis, because we all deserve to drink, and it is possible to be happy, but is even more possible to be content. Only after we acknowledge who we are – what drives us, what we want, what we love, what we hate, and loath, and despise, and worship, and desire – that we are able to do so. So, take my hand, and let us walk in this desert, together, in search of our next oasis.
Let’s get real. Life is fucking hard, and it has always been that way. Existing, in and of itself, is about as easy as trying to open a jar with oily hands. We walk around, day after day, going through the motions and lying to one another about how easy this whole thing really is. It is noteasy. We grant each person a carefully curated sliver of who we are, but beneath the surface we are so much more. We are not that sliver. We act like things are okay. They are not okay. Nothing is ever okay. We are not okay. We are humans. We are people. We are flawed, and ugly, and sad, and scared, and beautiful, and unique, and special. We are still those children trying to make sense of this impossible experience, one day at at time, and it is that journey through our existence that makes us so amazing. The things we do, every day, those are who we are, and we cannot let ourselves become too afraid to venture into the unknown and to redefine ourselves in our every waking moment.
So, let me help you. Let me do what we are all so afraid to do. Let me drop the charade, and show you exactly who I am, who I was, and how I got here. I will tell you right now that it was not easy. It was not obvious. It was not something I ever thought I could do on my own, and yet I did. There is darkness to my story, and it is essential, because without it, the light would not have a context in which to shine so radiantly. There is a dread to my story, and it too is essential; for without it, the hope would not have a stage to inspire us all. There is a desperation to my story, and without it, and without the hopelessness, and the fear, and the heartbreak, and the pain, and sorrow, and anguish, and all of things. All. Of. The. Things. Without them, none of what I have done would be remarkable.
So, I want you to remember something when you read this. I want you to remember that this is a story of hope. This is a story of success. This is a story of triumph. This is my story, and it can be yours too. No matter where and when we are in life, there is always hope. Even on the precipice of certain failure, there is hope. So long as there is breath in our body, there is hope. You are not foolish for wanting more, and you are not silly to think that there is more to our world than the day before today and the day before that. And while tomorrow is a fanciful assumption that leads us to sacrifice the now, today is real. Today is a day that you can do anything you set your mind to. Today is worth more than a million tomorrows; it is worth more than any amount of money; it is worth everything because it is the very definition of potential. Only in today, is there opportunity to choose how we exist.
It is the recognition, of the value of today, that gives us so much power in a world that aims to inoculate us to our own ability to realize our potential. There are people, and there organizations, and there are systems that profit from our paralysis. They profit from the fear that we live in, and they turn coin on the expectation that we will wait for tomorrow rather than capitalizing on today. Do not be afraid. Do not wait. Do not expect that your life will magically improve if you just keep doing the same fucking thing, day after day, after day, after day, after day until we are all fucking dead.
I made a choice, in my life, to change something so fundamental, so seemingly immutable and solid, like transforming the color of the Sun. It seemed impossible to me, that I could ever live as a woman in this world, that I could wake up in the morning to a smile instead of a grimace; that I could look to the mirror and see a feminine softness instead of a rough masculinity; that I could wear a dress on a hot day in June; that I could blush as a stranger called me, “miss” or “ma’am;” that I express to the world who I knew I truly was inside; that I could live every day in my own truth, comfortable in my own skin, and embodying an authenticity and an integrity, so pure, that I could close my eyes, every night, and never fear that they might not open again. Indeed, it seemed the very definition of impossible. As a man, assigned a boy at birth, as a person who spent each wakeful moment conforming to an identity that betrayed my true self, as a woman trapped in a prison made of “should” and “ought to,” I can tell you that I never thought I would realize this day.
Yet, here I am. I am doing just that: being. I am being exactly who I am, and I want you to be who you are. I want you to drop the veneer. I want you to breathe. I want you to be honest – more honest than you have ever been in your entire life. I want you to step into yourself, fully – whatever that may look like – and embrace your identity. This is who you are, and it is was makes you so valuable in the world. Homogeny is no commodity, and it is a poison that hurts us all. Nothing is the same. Everything is different. So why should we not all celebrate those differences together? Why should we have to lay in bed at night, turning over our worries and retracing our paths in an endless cycle of “what if?” Truthfully, we don’t. I don’t, and you shouldn’t. You are beautiful. We all are, in our own ways. We knew this as children. We knew that we hated lettuce, and we knew that we loved crayons, and pretend, and song, and dance, and being free. Yet somewhere along the way, we were hurt. In that trauma, we lost our willingness to wear our hearts on our sleeves and our openness to the pursuit of our wildest dreams.
I don’t have answers for you, but I have a story, and a method, and an audacity to dream of a more perfect version of it all that I will never realize. We will never be perfect, but every day, we can wake up, make choices, and go to sleep. We can, every day, step into our lives and choose to be exactly who we want to be. So, step into your life, today, and trust me when I say that nothing will feel better than being who the fuck you really are.